Genetic Mechanisms in Aspirin-Exacerbated Respiratory Disease

Aspirin-exacerbated respiratory disease (AERD) refers to the development of bronchoconstriction in asthmatics following the exposure to aspirin or other nonsteroidal anti-inflammatory drugs. The key pathogenic mechanisms associated with AERD are the overproduction of cysteinyl leukotrienes (CysLTs) and increased CysLTR1 expression in the airway mucosa and decreased lipoxin and PGE2 synthesis. Genetic studies have suggested a role for variability of genes in disease susceptibility and the response to medication. Potential genetic biomarkers contributing to the AERD phenotype include HLA-DPB1, LTC4S, ALOX5, CYSLT, PGE2, TBXA2R, TBX21, MS4A2, IL10, ACE, IL13, KIF3A, SLC22A2, CEP68, PTGER, and CRTH2 and a four-locus SNP set composed of B2ADR, CCR3, CysLTR1, and FCER1B. Future areas of investigation need to focus on comprehensive approaches to identifying biomarkers for early diagnosis

Attack of Many Eavesdroppers via Optimal Strategy in Quantum Cryptography

We examine a situation that $n$ eavesdroppers attack the Bennett-Brassard cryptographic protocol via their own optimal and symmetric strategies. Information gain and mutual information with sender for each eavesdropper are explicitly derived. The receiver's error rate for the case of arbitrary $n$ eavesdroppers can be derived using a recursive relation. Although first eavesdropper can get mutual information without disturbance arising due to other eavesdroppers, subsequent eavesdropping generally increases the receiver's error rate. Other eavesdroppers cannot gain information on the input signal sufficiently. As a result, the information each eavesdropper gains becomes less than optimal one.Comment: 17 pages, 8 figure

Influence of Physical Activity Level on Cardiovascular and Autonomic Nerve Function

PURPOSE The purpose of this study was to demonstrate differences in cardiovascular and autonomic nerve function among physical activity levels and associations between physical activity level and cardiovascular and autonomic nerve function. METHODS Sixty-six healthy young adults voluntarily participated in this cross-sectional study. Physical activity levels were assessed using triaxial accelerometers for 7 consecutive days. Central hemodynamics and arterial stiffness were measured using the Sphygomo-Cor Xcel system. Autonomic nerve function was assessed by heart rate variability. RESULTS The highest tertile group of the total quantity of physical activity had higher lnRMSSD than did the lowest tertile group (p=0.047). The augmentation index adjusted for heart rate at 75 beats per min (AIx@75) was lower in the highest tertile group of vig-orous-intensity physical activity than in the lowest tertile group (p=0.012). Moreover, AIx@75 was negatively associated with vigorous-intensity physical activity (r=-0.27, p=0.028). CONCLUSIONS High levels of physical activity contribute to the dominance of parasympathetic nerve activity at rest. Increased engagement in vigorous-intensity physical activity can help reduce arterial pulse wave reflection, an independent risk factor for cardiovascular diseases, even in healthy young adults

Deep learning computer-aided detection system for pneumonia in febrile neutropenia patients: a diagnostic cohort study

Abstract Background Diagnosis of pneumonia is critical in managing patients with febrile neutropenia (FN), however, chest X-ray (CXR) has limited performance in the detection of pneumonia. We aimed to evaluate the performance of a deep learning-based computer-aided detection (CAD) system in pneumonia detection in the CXRs of consecutive FN patients and investigated whether CAD could improve radiologists diagnostic performance when used as a second reader. Methods CXRs of patients with FN (a body temperature ≥ 38.3°C, or a sustained body temperature ≥ 38.0°C for an hour; absolute neutrophil count < 500/mm3) obtained between January and December 2017 were consecutively included, from a single tertiary referral hospital. Reference standards for the diagnosis of pneumonia were defined by consensus of two thoracic radiologists after reviewing medical records and CXRs. A commercialized, deep learning-based CAD system was retrospectively applied to detect pulmonary infiltrates on CXRs. For comparing performance, five radiologists independently interpreted CXRs initially without the CAD results (radiologist-alone interpretation), followed by the interpretation with CAD. The sensitivities and specificities for detection of pneumonia were compared between radiologist-alone interpretation and interpretation with CAD. The standalone performance of the CAD was also evaluated, using area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Moreover, sensitivity and specificity of standalone CAD were compared with those of radiologist-alone interpretation. Results Among 525 CXRs from 413 patients (52.3% men; median age 59years), pneumonia was diagnosed in 128 (24.4%) CXRs. In the interpretation with CAD, average sensitivity of radiologists was significantly improved (75.4% to 79.4%, P = 0.003) while their specificity remained similar (75.4% to 76.8%, P = 0.101), compared to radiologist-alone interpretation. The CAD exhibited AUC, sensitivity, and specificity of 0.895, 88.3%, and 68.3%, respectively. The standalone CAD exhibited higher sensitivity (86.6% vs. 75.2%, P < 0.001) and lower specificity (64.8% vs. 75.4%, P < 0.001) compared to radiologist-alone interpretation. Conclusions In patients with FN, the deep learning-based CAD system exhibited radiologist-level performance in detecting pneumonia on CXRs and enhanced radiologists performance

Occupational Rhinitis Induced by Capsaicin

Capsaicin is the spice component of red pepper. It can be easily inhaled, inducing a reproducible cough and provokes a secretory response from the human nasal mucosa. To date, there has been no report of occupational rhinitis (OR) caused by capsaicin. We report the case of a 44-year-old female mill worker who developed occupational rhinitis after 4 years of exposure to capsaicin. She developed nasal congestion, rhinorrhea, and itchy nose, which were all aggravated upon exposure at the workplace. The patient had negative responses to all common inhalant allergens, including capsaicin, by skin prick tests. The nasal provocation test with capsaicin showed that the nasal symptom score and eosinophil count increased 10 minutes after the provocation and decreased after 1 to 3 hours; no significant response was noted to house dust mite allergen. The patient's work-related rhinitis improved 1 month after she relocated and started pharmacological treatment. To our knowledge, this is the first case of OR caused by capsaicin exposure in the workplace. We provide evidence suggesting that OR may be mediated by a non-immunological mechanism